14 - Movement Disorders

Question 1

Movement disorder classification: Hypokinetic
– Parkinsonism

Answer 1

Question 2

Movement Disorders –
Parkinsonisms

Answer 2

Parkinson’s Disease
Lewy Body Dementia
Multiple System Atrophy (MSA)
Progressive Supranuclear Palsy (PSP)
Corticobasal Syndrome (CBS)
Vascular Parkinsonism
Post Traumatic Parkinsonism
Secondary (Toxin, Medication, Metabolic)

Question 3

Parkinsonism and Intracellular Proteins

Answer 3

Question 4

Overlap of tauopathies

Answer 4

Question 5

Parkinson’s disease diagnostic criteria

Answer 5

Bradykinesia PLUS
Tremor/Rigidity
Late postural instability
All secondary causes are not present
Persistent asymmetry
Good response to levodopa

Question 6

Parkinson’s Disease - general info

Answer 6

Question 7

Parkinson’s disease - pathology & epidemiology

Answer 7

Question 8

Imaging the DA System:
Dopamine Transporter & D2 Receptor SPECT

Answer 8

Question 9

Parkinson’s disease pathology

Answer 9

-Alpha synuclein is a primary constituent of Lewy bodies
-Increased aggregation of α-Syn leads to cell death

Question 10

Parkinson’s Disease mild off and on

Answer 10

Question 11

Medications used for Parkinson’s disease

Answer 11

Question 12

PD: Treatment

Answer 12

Question 13

PD Treatment Surgical Approaches
Deep Brain Stimulation (DBS)

Answer 13

Question 13

Complications of PD therapy

Answer 13

Question 14

Parkinson’s disease late off and on

Answer 14

Question 15

Parkinson’s disease dyskinesia

Dyskinesia is a movement disorder that often appears as uncontrolled shakes, tics, or tremors.

Answer 15

Question 16

Multiple System Atrophy - cardinal findings

Answer 16

Question 17

Autonomic Dysfunction in Multiple System Atrophy (MSA)

Answer 17

Question 18

Progressive Supranuclear Palsy

Answer 18

Question 19

Progressive Supranuclear Palsy:
Clinical Features

Answer 19

* Parkinsonism
o Symmetric
o Early gait/balance
o Falls in 1str year
o Tremor uncommon
* EOM
o Supranuclear palsy
o Square wave jerks
o Absent optokinetic
nystagmus
* Other motor
o Neck extension
o Bulbar dysfunction
o Limb dystonia
* Cognitive
o Frontal dementia

Question 20

Corticobasal Syndrome

Answer 20

Asymmetric Parkinsonism with Poor Response to Levodopa

Apraxia and Alien Limb
Spasticity, Rigidity, Dystonia
Gait and Balance Problems
Dementia always occurs, but may be a late feature

Question 21

Medication induced movement disorders - medications

Answer 21

Question 22

Medication induced movement disorders - classification and symptoms

Answer 22

Question 23

Essential Tremor

Answer 23

Question 24

Chorea - background/definition

Answer 24

Question 25

Chorea - Causes

Answer 25

Question 26

Huntington’s Disease Clincial Features

Answer 26

Question 27

Huntington’s Disease - info

Answer 27

Question 28

Myoclonus

Answer 28

• Sudden, brief, shock-like involuntary movements caused by muscular contraction or inhibition, originating either in the central or peripheral nervous system

Question 29

Myoclonus: what is the cause (differential diagnosis)?

Answer 29

Question 30

Myoclonus: treatment

Answer 30

Question 31

Tics

Answer 31

Question 32

Tourette Syndrome

Answer 32

Question 33

Dystonia: Definition

Answer 33

Question 34

Three features unique to dystonia

Answer 34

Although they are not always present, when they are, “it must be dystonia”

• Task-specificity: selective activation of involuntary
  movements by specific tasks (e.g. writing, using a computer mouse, playing a musical instrument).
• Geste antagoniste: a sensory trick that improves the dystonic phenotype while it is applied (touching the chin, touching the eyes, holding an object between the teeth).
• State function: variation in severity of dystonia with specific actions (walking backwards but not forwards, speaking but not eating).

Question 35

Ataxia

Answer 35

Question 36

Ataxia - history

Answer 36

Question 37

Friedreich’s ataxia

Answer 37